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Abstract

Background: Use of Analysis during Compressions with Fast Reconfirmation (ADC-FR) technology, which features automated rhythm analysis and charging during chest compressions (CCs) with a brief reconfirmation analysis during CC pause, has been shown to reduce CC interruptions compared with standard AED operation. The purpose of this study was to determine the accuracy of the ADC-FR algorithm.

Methods: A retrospective analysis was conducted of AED Pro and AED Plus defibrillator records (ZOLL Medical) containing ECG and CC acceleration data, collected as part of a registry, from the treatment of 624 out-of-hospital cardiac arrest patients. With ADC-FR, the ECG rhythm is interpreted during CCs using an advanced algorithm and the defibrillator is charged the last 10 seconds of the CC interval. A quick reconfirmation analysis is initiated after the rescuer stands clear to confirm the shock/no-shock result of the analysis performed during CCs. If the analysis during CC and reconfirmation analysis agree, the defibrillator is immediately armed (if shockable) or disarmed (if non-shockable). If the reconfirmation analysis and analysis during CCs differ, an additional analysis is conducted. For ADC-FR testing, the CC acceleration signal was used to identify CC intervals followed by a CC-free period of at least 6 seconds (for reconfirmation analysis) and the ADC-FR algorithm was applied. The analysis results were saved in text files, which were used to calculate algorithm accuracy.

Results: A total of 2059 advisories were generated by the ADC-FR algorithm. As shown in the table, the ADC-FR advisory algorithm accuracy exceeded the AHA performance goals for all rhythms.

Conclusions: The ADC-FR algorithm produces accuracies better than performance goals recommended by AHA even though the performance goals are for algorithm tests with artifact-free ECG signal. Therefore, the ADC-FR can be used to reduce CC pauses while preserving shock decision accuracy.